Japanese Exchange Program Application Step 1 of 5 20% Student InformationName(Required) First Last School Major(Required) Weight Category (Judo)N/AMEN: Extra Lightweight-60 kg (132 lbs)MEN: Half Lightweight -66kg (145 lbs)MEN: Lightweight -73 kg (160 lbs)MEN: Half Middleweight -81kg (178 lbs)MEN: Half Heavyweight -90 kg (198 lbs)MEN: Heavyweight-100 kg (220 lbs)MEN: Open Weight +100 kg ( +220lbs)WOMEN: Extra Lightweight-48 (105 lbs)WOMEN: Half Lightweight-52 (114 lbs)WOMEN: Lightweight-57 (125 lbs)WOMEN: Half Middleweight-63 (138 lbs)WOMEN: Half Heavyweight-70 (154 lbs)WOMEN: Heavyweight-78 (171 lbs)WOMEN: Open Weight+78 (+171 lbs)Favorite TechniquesAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country Primary Phone(Required)Alternate PhoneEmail(Required) Referring PartyName(Required) First Last Organization(Required) Position(Required) Primary Phone(Required)Secondary PhoneEmail(Required) Relationship to Applicant(Required) Specifics of the StayLength of Stay(Required) < 3 months 3-6 months > 6 months Undecided Preferred dates(Required)Do you want to attend English classes?(Required) Yes No Undecided Short EssaysIf you had to choose just one word to describe yourself, what would you choose?(Required)Have you ever traveled abroad? What do you know about the United States and Oregon?(Required)Why do you want to visit / live in the US?(Required)Why do you want to be admitted to our program?(Required)What do you hope to gain from your time in Oregon?(Required)What do you hope to contribute to Pacific Rim and its students?(Required)What is one thing you respect about your sensei?(Required)What is one of your greatest achievements? Please tell us about it.(Required)What do you rate as your greatest personal strengths and weaknesses?(Required)What is one part of American culture that you are excited to experience?(Required)What is one part of Japanese Culture that you would like to share with Americans?(Required)What do you do in your spare time? What hobbies or interests do you have?(Required)Why do you practice martial arts? Please describe one thing martial arts has done to improve your life?(Required)In 10 years, where would you like to be living, and what would you like to be doing?(Required) Exchange Program Application FeePlease submit your $100 application fee using the payment form below.Exchange Program Application Fee(Required) Price: Credit Card(Required)Card Details Cardholder Name PhoneThis field is for validation purposes and should be left unchanged. Δ